Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. WALLACE MAXWELL GREEN, PAC
ActiveMR. WALLACE MAXWELL GREEN, PAC is a Neurology healthcare provider located in FAYETTEVILLE, Georgia. NPI 1306979059 is currently active in the NPPES registry. Verify at CMS.
Neurology · FAYETTEVILLE, GA
Registration Details
- NPI Number
- 1306979059
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 13, 2007 (19.398011361523 yrs)
- Last Updated
- Jul 8, 2007
- License
-
001827 (GA)
Practice Information
- Address
-
1275 HIGHWAY 54 WSTE.105FAYETTEVILLE, GA, 302144549Browse GA providers · Browse ZIP 30214
- Phone
- 7707192965
- Fax
- 7707192963
- Primary Specialty
-
Neurology
2084N0400X
Other Neurology Providers in FAYETTEVILLE, GA
| Name | Credential | NPI |
|---|---|---|
| MR. VIRENDRA V RANADIVE | MD | 1447211149 |
| DR. KENNETH J LAZARUS | MD,PHD | 1689602385 |
| DR. SONAL RAMESHCHANDRA HAZARIWALA | MD | 1457579492 |
| KRISHNA J GOLI | M.D. | 1932384427 |
| DR. LISA M AVERY | M.D. | 1699008409 |
| EVAN MCCARROLL JOHNSON | MD | 1023547890 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.